Coding Quality Review Specialist (Outpatient)

Performs coding quality reviews on Outpatient Medical Records. Qualifications EDUCATION: High School graduation or equivalent. Bachelors degree preferred, with successful completion of medical terminology, anatomy, physiology, and coding courses in ICD-10-CM and CPT-4. EXPERIENCE: 2 years outpatient coding experience, preferably in an acute care setting and 1 year auditing experience preferred. LICENSE/CERT/REG: AHIMA (American Health Information Management Association) CCS-P (Certified Coding Specialist- Physician), CCS (Certified Coding Specialist) or AAPC (American Academy of Professional Coders) - COC (Certified Outpatient Coder) required. Certification as a Registered Health Information Technician (RHIT) or Registered Health Information Administrator (RHIA) preferred. SKILLS: Excellent verbal and written communication skills. Excellent interpersonal skills, Good public speaker and presenter. Basic computer skills preferred. Primary Duties and Responsibilities Assists with the development of system-specific coding guidelines as needed, and participates in Quality review team meetings. Contributes to the achievement of established department goals and objectives and adheres to department policies, procedures, quality standards and safety standards. Complies with governmental and accreditation regulations. Having knowledge of coding compliance plan, directs efforts to achieving plan by focusing on areas identified through coding reviews or targeted by management for improvement. Helps select areas for focused quality reviews. Maintains continuing education. Maintains credentials, for required job classification. Meets established Quality, Accuracy, and Productivity standards as defined by policies. Participates in multidisciplinary quality and service improvement teams. Participates in meetings and on committees and represents the department and hospital in community outreach efforts. Performs other duties as assigned. Provides/identifies trends to provide feedback to appropriate sources. Identifies and assists in areas to provide additional training/education, under the direction of Manager. Responsible for retrospective and concurrent reviews on coding staff. Reviews, analyzes, and interprets medical record documentation to identify diagnoses and procedures. Assigns correct ICD and/or CPT diagnostic and procedural codes using standard guidelines and automated encoding software. Assigns the appropriate DRG. Works closely with the Coding Quality Review team and outpatient coding staff to identify areas for improvement and problematic cases. About MedStar HealthMedStar Health is dedicated to providing the highest quality care for people in Maryland and the Washington, DC, region, while advancing the practice of medicine through education, innovation and research. Our 30,000 associates and 5,400 affiliated physicians work in a variety of settings across our health system, including 10 hospitals and more than 300 community-based locations, the largest visiting nurse association in the region, and highly respected institutes dedicated to research and innovation. As the medical education and clinical partner of Georgetown University for more than 20 years, MedStar is dedicated not only to teaching the next generation of doctors, but also to the continuing education and professional development of our whole team. MedStar Health offers diverse opportunities for career advancement and personal fulfillment.